Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Beletsioti Chrysoula
Dissertation committee:
Δημήτρης Νιάκας, Καθηγητής, Τμήμα Ιατρικής, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Πέτρος Σφηκάκης, Καθηγητής, Τμήμα Ιατρικής, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Ανδρέας Καραμπίνης, Καθηγητής, Τμήμα Ιατρικής, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Ιωάννης Μπολέτης, Καθηγητής, Τμήμα Ιατρικής, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Γεράσιμος Σιάσος, Καθηγητής, Τμήμα Ιατρικής, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Κωνσταντίνος Μακρυλάκης, Καθηγητής, Τμήμα Ιατρικής, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Μαρία Ράικου, Αναπληρώτρια Καθηγήτρια, Τμήμα Οικονομικής Επιστήμης, Πανεπιστήμιο Πειραιώς
Original Title:
Η επίδραση της οικονομικής κρίσης στην υγεία και τη χρήση υπηρεσιών υγείας των κατοίκων της Ελλάδας
Translated title:
The impact of economic crisis on health status and health services utilization in Greece
Summary:
Background/Aim: In 2009, Greece entered a prolonged recession period and adopted austerity measures, which have profoundly affected many aspects of social sector, including health sector. The objective of this study was to investigate health status and health services utilization in the Greek population in the context of the crisis and its determinants.
Methods: Two cross-sectional surveys of the adult residents of Athens conducted in 2003 and 2016 surveys were used to analyze possible changes in Health-related Quality of Life and estimate the role of the economic crisis and other demographic and socio-economic factors. Additionally, two National Health Surveys of the population aged 15 and over, conducted in 2009 and 2014 were used to investigate trends in healthcare utilization and its determinants. Mann–Whitney tests and chi-square tests were applied to estimate possible statistically significant differences and regression analyses were performed to identify significant determinants of health status and healthcare utilization.
Results: Physical component summary score (PCS) has improved and Mental Component Summary score (MCS) has deteriorated. The most important determinants of PCS were age, gender, being retired and low income and of MCS age, being divorced or widowed and financial crisis conditions (survey year was used as a proxy measure of crisis). Between 2009 and 2014, the percentage of participants who reported one or more chronic health problems increased and the percentage of those with very bad/bad/fair health status did not change significantly. The most important predictors of self-rated health status were age, educational attainment, being retired, morbidity and experiencing pain and regarding self-reported morbidity, age, being divorced/widowed and retired had the strongest impact. Additionally, the share of those who had visited a specialist decreased, the share of same-day patients increased, whereas that of those who had visited a general practitioner or had been hospitalized did not change significantly. The strongest predictors of outpatient healthcare utilization were self-rated health and being surveyed in 2014, while concerning inpatient care, need-related factors had the strongest effect.
Conclusions: Identifying the procyclical or counter-cyclical nature of health status and healthcare utilization and the association with their determinants is an important priority in order to improve access and promote health equity.
Main subject category:
Health Sciences
Keywords:
Economic crisis, Health status, Health care utilization, Greece
Number of references:
259
